Bariatric Specialists of North Carolina

In by OC StaffFebruary 24, 2017

Bariatric Specialists of North Carolina is proud to be the premier, private weight loss surgery and weight management center in the South.

With over ten office locations in Burlington, Durham, Raleigh, Cary, and Wilson, our providers are dedicated to educating the population about the dangers of obesity and equipping them with the surgical and non-surgical tools necessary to begin and continue along their weight loss journey.

Our surgeons and staff have developed a comprehensive approach to care, which we personally tailor to meet each patient’s specific needs. After completing our program, patients find themselves medically, physically, and emotionally prepared for long-term success and health.

BSNC offers many programs, including surgical and non-surgical weight loss solutions. We have a fully comprehensive, self-funded/cash pay program for bariatric surgery and accept third party financing. We never want finances or insurance to be your barrier to optimum health and wellness.

**Pricing for the intragastric balloon program includes all costs associated with the yearlong program (implant, explant, office visits, pre-procedure screening). Procedure pricing includes all costs associated with the day of surgery (anesthesia, facility fees, surgeon fees) and five years of office visits. Patients must undergo a full pre-operative screening and must be medically cleared by the surgeon and anesthesiologist.

Below is more in-depth information about BSNC’s Surgical and Non- Surgical Programs.

Non-Surgical Weight Loss Program

We understand weight loss surgery may not be the best option for everyone. We offer physician supervised weight management programs with our very own bariatrician to aid patients who do not meet insurance criteria for surgery or wish to try alternatives prior to undergoing surgery.. Additionally, we offer programs to surgical candidates to help them optimize health prior to surgery. Our goal is to help patients create lasting nutrition and lifestyle habits to keep their weight under. Participants receive education and support from our medical and dietary staff as well as a personalized weight loss plan, unique to their specific goals and challenges.

Intragastric Balloon Program

As a middle ground between physician supervised weight loss and bariatric surgery, we offer the intragastric balloon procedure. The balloon received FDA approval in the United States in 2015 and has been widely used in Europe, Australia and South America for the past twenty years.

Our twelve-month program is ideal for patients who do not wish to undergo a permanent procedure, however, need more of a tool to aid in their weight loss. After an initial evaluation and preparation, a balloon is placed during an outpatient procedure under light sedation. The saline filled balloon is placed endoscopically into the upper portion of the stomach, limiting its capacity while creating a restrictive effect. Patients find they feel satisfied after eating a smaller meal and therefore lose weight. The balloon is designed to stay in the stomach for six months and is removed during an outpatient procedure under anesthesia. For these six months and over the following six months, patients receive comprehensive education and support from our nutritional and medical staff. Our goal is to help patients establish sustainable, healthy habits that will last a lifetime. It is important to note this procedure is currently not covered by any insurance company and is only available as a self-funded program.

The lap-band is considered a restrictive procedure, which involves placing an adjustable band around the upper portion of the stomach. This creates a small pouch. Patients eat less and become full faster by filling up this small pouch above the band. Also important is stimulation of nerves of the stomach with the band. The band causes compression on the nerves that then signal the brain that fullness is occurring.

About a month after surgery, the first band adjustment is done. During an office visit we will ask about your level of hunger, the amount and types of food you are eating, how often you are eating and how much weight you are losing. Depending upon your progress, we will access the port with a fine needle to add fluid, remove fluid or do nothing at all. These adjustment visits take place every four to six weeks for the first year until we find your band’s “sweet spot”.

The “sweet spot” is where you are able to eat a small amount of food, feel full and not get hungry in between meals. It may take three to five adjustments to get to this point. Once the band is optimized, you should lose about half a pound to a pound a week.

Sleeve Gastrectomy

The vertical sleeve gastrectomy or gastric sleeve, as it is more commonly known, is currently the most common weight loss surgery performed in the United States. The sleeve is created by removing the outer ½ to 2/3 of the stomach creating a smaller reservoir, therefore patients feel full after eating a smaller amount of food. By removing a portion of the stomach, hormone production that leads to hunger is reduced significantly, reducing cravings of urges to eat large quantities of food.

Patients undergoing this procedure will lose on average 70% of their excess weight within the first year after surgery. The sleeve gastrectomy is an excellent option for patients who want a procedure that is less invasive than a gastric bypass but do not want a permanent, mechanical device in their body.

Roux-en-Y Gastric Bypass

The roux-en-y gastric bypass was first performed by Dr. Edward Mason over 50 years ago and is still considered the gold standard for weight loss surgery today. The surgeon creates a stomach pouch about the size of an egg and then bypasses 25% of the small intestines. The new stomach pouch limits the amount of food patients can consume in one sitting. In bypassing a portion of the intestines, we limit the time food can mix with digestive juices which drives production of hormones that prolong satisfaction with less food.

One attribute specific to the bypass is dumping syndrome, which some patients view as both a positive or negative. Patients who eat too much fat or sugar during a meal may “dump” or experience symptoms of nausea, sweating, fatigue, weakness and diarrhea. It is your body’s way of telling you that you just ate the wrong thing.

Patients can expect to lose about 60% to 75% of their excess weight within the first year after surgery. Patients can also expect resolution or improvement of medical conditions such as hypertension and diabetes, often within the first few weeks or months after surgery.

Duodenal Switch

The duodenal switch is a weight loss operation that has been done for over 20 years but has increased in frequency significantly in the last several years. It has the greatest weight loss potential of all the operations available. It works by creating a sleeve gastrectomy for restriction and hunger control. Then after the sleeve the intestines are rerouted similar to a gastric bypass. The principle measured length with a duodenal switch is the common channel. This is the distance from where bile and food meet to the end of the intestines and determines the amount of malabsorption.

This common channel distance is an important number and has changed significantly over time. Originally this number was 50-100 cm and while it provided excellent weight loss, it left patients with nutritional deficiencies and diarrhea. We currently do a common channel length of 250-400 cm dependent on the patient’s needs and this appears to be the sweet spot where weight loss is still excellent with fewer downsides. Vitamin supplementation is important and patients may have some increase in the number of bowel movements.

The ideal patient for a duodenal switch is a patient who has more weight to lose. We know that patients will lose more weight than the other surgical options. Particularly patients with a BMI over 50 will have better and more sustained weight loss than with other procedures. Additional benefits are a lower incidence of ulcers than a gastric bypass operation. This is particularly helpful for patients that need to take NSAIDs such as aspirin, ibuprofen etc.

Patients can expect to lose 80-90% of excess weight in the first year after a duodenal switch operation.

Over the last few years, a simpler version of the duodenal switch has become an option. This is known as the Single Anastomosis Duodenal Switch (SIPS) or SADI procedure. Instead of a roux-en-y configuration with 2 connections, a single connection is made in a so called loop configuration. By having 1 connection instead of 2, the surgery is performed more quickly and with less risk of leak. Because the procedure is relatively new, not all insurance companies are covering it.

Bariatric Specialists of North Carolina is proud to offer patients the option of robotic weight loss surgery. Robotically assisted surgery represents the latest in technological advancement in the field of bariatrics. Our practice currently performs most types of weight loss surgery utilizing the robotic platform.

Your surgeon controls the robot, by manipulating it’s robotic arms from a console located within the operating room. By allowing for an enhanced 3-D view of the patient’s anatomy, robotic surgery has potential benefits for the patient by shortening hospital stays, decreasing pain, and aiding in a quicker recovery.

It is important to realize not all patients are candidates for robotic procedures and the standard risks associated with surgery still apply.

SILS Procedures

Single Incision Laparoscopic Surgery (SILS) is minimally invasive surgery. The surgeon operates exclusively through a single entry point instead of the traditional four or more laparoscopic incisions. Many times this incision can be hidden within the belly button so patients are truly left with no visible scars.

Only certain surgeries may be performed via this technique: lap-band, sleeve gastrectomy, gallbladder removal, and hernia repairs. SILS benefits the patient by causing less scarring, decreased incision site pain, faster recovery time and reduced risk of wound infections.

Not all patients are not candidates for SILS. The determination depends on many factors including the size of the patient’s liver, Body Mass Index (BMI) and previous surgical history.